eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2021-03-14 9 5 298 300 10.12691/ajmcr-9-5-10 AJMCR20219510 article Eman EL-Sawalhy Eman.elsawalhy@beaumont.org 1 Wehbi Hnayni 1 Sarah Lonardo 2 Shahina Patel 3 Department of Internal medicine, Beaumont Hospital, Dearborn, MI 2Department of Hematopathology, Wayne State University School of Medicine, MI Division of Hematology & Oncology, Internal Medicine Department, Beaumont Hospital, Dearborn, MI Grey zone lymphoma (GZL) remains a challenging diagnosis because it has mixed features of diffuse large B cell lymphoma (DLBCL) and classic Hodgkin lymphoma (cHL). In this case report, we present a 69-year-old man who was diagnosed with GZL after an incidental finding of right axillary lymphadenopathy on Computed tomography (CT) scan during a recent hospitalization for an ischemic stroke. Excisional biopsy of the axillary node pathology was consistent with classic Hodgkin lymphoma (Nodular Sclerosing type). Subsequent Positron Emission Tomography (PET)/CT scan showed adenopathy above and below the diaphragm, as well as possible liver, bone, and colon disease. Liver biopsy revealed pathology consistent with DLBCL contrary to the Hodgkin disease seen on axillary biopsy resulting in an eventual diagnosis of GZL on further pathology review. http://pubs.sciepub.com/ajmcr/9/5/10/ajmcr-9-5-10.pdf Grey zone lymphoma B cell Lymphoma classic Hodgkin Lymphoma